The opiate antagonists in the treatment of intractable pruritus in a patient with cirrhosis

The treatment of pruritus in liver diseases, due to the poor knowledge of its exact etiology and pathogenesis, is difficult and often unsuccessful. Pruritus can determine a worsening of life quality and serious sleeping troubles, and is considered an indication for liver transplantation itself. The case of a 64-year-old female with post-C-hepatitis cirrhosis and incohercible pruritus, treated with opiate antagonists: naloxone and naltrexone is presented. The patient responded soon and positively to therapy and did not show any of the typical side-effects of opiergic tone inhibitors. The satisfying results of this experience demonstrate the predominant role of endogenous opioids in the genesis of pruritus of cholestasis and the efficacy of opiate antagonists in controlling the itching.